Since the late 1980s, support has been growing for a "systemic" vision of reform that would pair ambitious, coordinated state policies with professional discretion at the school site. Policymakers at all levels of government, as well as associations, foundations and national agencies, support this approach. This paper highlights issues and strategies that characterize the unfolding of systemic reform in the United States. Drawing from research on state-reform efforts conducted over the years by the Consortium for Policy Research in Education, the paper discusses issues such as the following: (1) What vision drives systemic reform? (2) What policies are included in integrated strategies? (3) Which policy instruments should states use to "lead" systemic reform? (4) How can the public and professionals be involved in the reform process? (5) How is political support for systemic reform built and maintained? (6) How can "bottom-up" reforms be incorporated with state-led curriculum guidance? (7) Do school personnel have the capacity to promote student outcomes? (8) What are the equity implications of systemic reform strategies? and (9) Can the development of systemic reform strategies withstand state fiscal stress? (Contains 66 references.) (Author)